The effect of home monitoring and telemanagement on blood pressure control among African Americans

Hypertension is disproportionately prevalent among African Americans compared with other ethnic groups. Furthermore, research demonstrating effective management strategies for this group is limited. The objectives of this study were to determine: (1) compliance with home blood pressure monitoring among hypertensive African Americans, and (2) the effectiveness of telemanagement in blood pressure control within 1-3 months. Participants used a transtelephonic home monitor that transmitted their blood pressure daily via their existing telephone lines to a university sewer system. A one-group, pre-post design was used. The sample included 33 African Americans (age 51.5 +/- 14.3, 70% female) with uncontrolled blood pressures despite pharmacological treatment for greater than or equal to 1 year. Interventions were conducted over the phone, including patient education and medication titration congruent with JNC-VI guidelines. Daily data were transmitted by 88% of the sample; significant decreases (p less than or equal to 0.001) in mean systolic (154.1 +/- 16.0 to 141.4 +/- 12.2 mmHg) and diastolic (89.9 +/- 9.6 to 83.2 +/- 9.6 mmHg) blood pressures; and 60% (p less than or equal to 0.001) achieved blood pressure control within 1 month. Significant blood pressure improvements (p ( 0.001) were maintained throughout the study. Additionally, disease knowledge was improved (p < 0.002), and some lifestyle modifications were demonstrated including mean weight loss (p less than or equal to 0.02); quality of life, which was rated as 'satisfying' at baseline, did not change. African American patients in this sample were compliant with the required home monitoring and blood pressure control in a relatively short time. Other beneficial psychosocial and behavioral effects were demonstrated.